Drugs – Niche-Me…

Doctor messes up.

I’m… well… very angry. If I could get this guy fired and reported to some agency to keep him from prescribing medications, I would. Darn straight! 

This “doctor” (He’s a PA-C. I don’t even know what that is. I know what a PA is. What’s the “C”? Crackpot?) Okay, back to why I’m so angry. 

Last time I saw this guy, let’s call him JH, he was reciting out loud what medications he was sending electronically to the pharmacy for a refill. As he was reading them, he said, “Lamotrigine–” To which I said, quite firmly, “No, that’s not one you fill. You’ve never filled that. S fills that.”

The guy’s never ordered this for me. Why would he? This is my mental health person’s job. He’s NEVER filled this for me. (I know I’m repeating myself. I’m hoping the Universe or something will smack him.) He does Oxycodone, Lyrica, and the one for restless legs. He’s my pain mgmt prescriber. (This should be scaring you.)

“Do NOT fill that drug.”

I was so mad. The pharmacy told me to call his office and inform them of the mistake. So, I did. No one would talk to me. I was sent to his PA’s voice mail. No one ever called back. 

I also called my mental health clinic and left another message, this time for them. I wanted them to be aware of the problem. A floater nurse called me back pretty quickly. We were on the phone about 18 minutes. She had no idea what the heck was going on. Eventually, about 2 minutes before I needed to leave to go to her actual building to see my counselor, she let me go. 

You know what the result of that conversation was? She concluded that my regular MP (med provider) had been weening me off Ritalin and that now I should have stopped taking it completely. 

I responded the only way I could – “Yeeeeessss?” I mean, what if she found out that I was still taking them? I was already getting paranoid at this point so I didn’t know what to say. I’m really am supposed to be taking it. My counselor (L) and I had just decided that I needed to ask to have it increased!

When I got to see L, he told me that he’d already gotten the email telling him what had happened. I told him about the Ritalin issue. He looked at my chart and immediately said that it was clear that I was was supposed to be on it. In fact, I was supposed to be taking the two pills. 

Sigh. So, now I have too much Lamotrigine and no Ritilan. I’m angry. 

This morning we took my Emotional Support doggie to the vet. She vomited blood right after vomiting on my bed. Thankfully, she’s going to be okay!

I’m stressed and weary. 

Angry. Stressed. Weary. Sigh

Idiots

My Millennials help me now. I have three. They help monitor my meds. The one that lives with me fills my medication box thingies. The second one lives down the street and comes by to visit and help out pretty often. The youngest is married and about to graduate from the same university that I did. 

I will not be killed by people who value my life so little that they cannot take the time, or get help, to read my chart properly or return my phone calls. 

I have managed all the stress from raising kids. I have not killed myself. I won’t be killed by these morons. I will protect myself. I will stand and not let stupid people sneak up on me. I fight with myself every day and I survive. I will survive these people too. 

Mel Robbins (I think it’s her) says that at the end of the day there will be no White Knight riding in to save you. No one is going to rescue you. You have to do it yourself.

There are frequent times when I can’t do this for myself, but today, this week, this moment, I can. I’m protecting myself. I’m going to do what I can to make certain that the people responsible for these screw-ups, won’t be able to do it so easily again. 

I’m pissed off. I haven’t killed myself. I’m not about to let incompetent medical professionals kill me. 

This is MY day. I will live it MY way. I will not let ANYONE take it from me. Not ever. 

Opioid Dependence and Mental Illness

Pile of pills

I’m not an addict. I’m not! I’m mentally ill. I have Bipolar Disorder. I also suffer from chronic pain in my lower back.

My primary care doctor (PC… PCD? Uhh… let’s go with MD) had been prescribing me oxycodone for the server and persistent (chronic) pain that I’ve had for years. After being active and doing something super strenuous like gardening for 15 minutes I think I’m dying. I’m exaggerating of course, but when I work as hard as Atlas does while holding up the world my eyes leak, I whimper and sit down. Sometimes I end up laying on the floor. The floor is such a very bad idea. If I straighten my legs my whimpering becomes desperate and I realize I’m crying. If I forget myself and straighten my legs I’m done. I can’t move. The pain paralyzes me.

I’m NOT an addict.

When I can think again, I try to find my phone. If I can’t find it right away I feel the panic rising and it triggers thoughts and emotions I thought I’d had under control.

This last time I thought I was managing my mania and depression (mixed state, rapid cycling) pretty well. I haven’t bought piles and piles of books on ducks or Oprah or how to be an astronaut. Honestly, I really haven’t. But please, don’t ask me what I’m thinking about. Also, I’ve been able to get out of bed AND wake-up in the morning and even go for walks. My depression skips through the dandelions with the mania comingling into a mixed state, which is always confusing.

I’m not an addict.

After many months of giving me a legal way to get my the Oxycodone I take for pain legally, and for free. The label on the bottle says I’m to take the little unassuming pills three times a day. They are 20 mg. Currently, I’ve convinced the assistant fellow at the pain clinic to reduce my Oxycodone to 20 mg twice a day.

I’m not an addict.

I’m mentally ill. I have Bipolar Disorder, ADHD, chronic pain, and other stuff.

I was referred to a pain chronic clinic… ah… chronic pain clinic, where my Oxycodone prescription was reissued. A five-minute verbal probe, that’s what it took for the doctor to determine whether or not I needed the narcotic. We didn’t talk about Bipolar Disorder or any potential interactions the Oxycodone might have with drugs that are meant to manage my wild emotions or tame my fantastic panic attacks. I’m not certain she has any record of my current medications. She asked questions, and I quickly tailored my answers to fit what I thought she was waiting to hear. She made a few notes on a paper as small as her palm. I wondered if she was actually making notes that she could refer to later. She thought for a few seconds and then wrote the prescription. I sighed in relief.

I’m not an addict.

A while later, like over a year or maybe two, I’m still taking the narcotic. The clinic has new owners and staff. They no longer asked me questions. Sometimes they required a urine test. Then, they stopped asking me anything at all. We spent my appointment chatting. I started asking if we could please try to figure out what was causing the pain and try to deal with it by correcting the problem. I wanted the pain to stop.

They didn’t listen. They wrote the prescription without hesitation.

I’m telling you, I’m not an addict.

My mental health drug dispenser began paying attention after I updated her about my drugs and included Oxycodone in the list. She stopped talking about whether or not my meds were working to stabilize my moods and started talking about “Black box” warnings.

She had my attention. I started to panic.

At the time I had over five medical people prescribing medications. They didn’t know what the other office prescribed me. They relied on me to tell them the truth. I didn’t have to tell anyone I was taking Oxycodone. That got me thinking.

I’m not an addict.

Later…

I’m still asking the medical folks to figure out the cause of my chronic lower back pain. I’m still not getting results. I’m getting way too much Oxycodone every bloody month.

Because I can, I’ve been researching my of collages of illnesses, disorders, and psychological malfunctions.

Ah ha! Black box warning. Do NOT take anti-anxiety medication (benzine’s) – death may result.

Oxycodone 20 mg

I recently saw Dr. T, my very superior knee surgeon. He saw the condition of my spine when he was looking at the x-rays of my hips. He was making certain that my persistent knee pain, post second replacement, wasn’t being caused by anything running amock in my hips. He was eliminating any possible cause of my knee pain before he even considering using surgery to further correct the inept effort Dr. B made the initial knee replacement. Dr. B successfully replaced my knee, but that’s where the project ended.

It sucked. My leg from the knee down, well, it kind of turned the wrong way.

Dr. T corrected the first replacement. He tried to minimize the damage his surgery could do while trying not to blow up my entire joint… okay, the joint that was already gone.

Dr. T showed me the x-rays he’d just had taken and explained where and why he left Dr. B’s “efforts,” while replacing the replacement. A month ago we tried a shot to relieve the pain and keep from having to have surgery again.

Nope. I’ve had no relief from the pain. In fact, my brain was overjoyed and thought that my knee was doing awesome. Holy cow! I should NOT have knelt down like that! Looks like surgery is probably what our next conversation will be about. I’ll need to be on pain medication again…. I intend to be off Oxycodine ASAP. I would really like to have some kind of painkiller to take after surgery – assuming I have it. Always be prepared! Sigh…

I’m not an addict.

After my constant complaining about my back pain that happens every time, I do regular human type activities involving the lower back. I’ve finally had x-rays of my back taken. Holy heck. Next stop is at a spine doctor.

The online personal information provided by my medical organization includes this: Opioid Dependence.

My chronic pain clinic instructs me to continue taking the Oxycodone. I haven’t been able to identify any specific relief from the pain in a long time. I have never felt any “fun” results from taking it. It has never made me feel sleepy.

I have found that taking Oxycodone at bedtime with the medication I take for Restless Legs Syndrome (RLS) helps me to get to sleep and not wake up in agony caused by the RLS.

Am I an addict?

“Taking opioids over a long period of time produces dependence, such that when people stop taking the drug, they have physical and psychological symptoms of withdrawal (such as muscle cramping, diarrhea, and anxiety). Dependence is not the same thing as addiction; although everyone who takes opioids for an extended period will become dependent, only a small percentage also experience the compulsive, continuing need for the drug that characterizes addiction.”*

I’m mentally ill. In my opinion taking any medication, especially one that alters my brain chemistry (opioids do this), should be thought about and discussed with other medical personnel who are also responsible for my continued living – and to live my best life.

Am I an addict?

No.

I have Opioid Dependence.

Dependence. I can live with that, but look, let’s get rid of that too. Okay?

{I have Bipolar Disorder. I’m a little manic now. I’m using it to write and post while I can. So, for now, I will post often because tomorrow, I may be depressed and unable to say what’s on my mind. I may not have anything on my mind.}

* https://ghr.nlm.nih.gov/condition/opioid-addiction

I R Niche You…

So yeah, I couldn’t think of what to call this episode of “Exploring the life and mind of the Great Un-Niche_Able Me. ”

Today’s post is all about what min brain did during the walk Bailey and I took today. My daughter asked me where it was all from and I said that it was just my brain, taking a walk with the dog.

map_nov27_2018edited_smaller

You think this is slow? I can go way slower. And, we may have gotten lost a few times.

I went to bed at 7 p.m. last night after falling sound asleep and breaking my neck in the recliner I inherited from my dad. It’s way too big for me. I’m about a foot from the floor and just cannot reach the lever to pull the chair together, but I manage because it was dad’s chair. Then I overslept because my brain thought it would be fun to turn itself on but not to do anything entertaining or useful.

I have ADHD. I have Bipolar Disorder. My brain is a place where clowns and squirrels are abundant, the skies are green, and I try to do everything, especially those things which are impossible, before 11 a.m., if I’m awake.

Bailey, my doggie, and I just got home from a walk. Less than five minutes later the rain started. Right after that, the mail lady arrived. We’d seen her halfway through our walk. She’s cool. Brings treats. Doggie bones by mail. Love it.

An indication that you’re not necessarily getting old, but that something is sure happening: you need to stop at the house halfway through your walk to go to the “you know what.” Reason? Two cups of coffee before setting off on the grand adventure which consisted of walking around my bit of South Tacoma. (What’s this? Fern Hill?)

I’ve been trying to decrease my minutes per mile. Walking with the doggie will always increase my time. Why? She just has to stop to doggie business repeatedly, and I mean business without a briefcase. Let me be specific in case you’re not from around here: she had to stop and have a bowel movement, she poopooed. (Was that too explicit?)

<How did I get all these stupid apps open?>

I have new Bluetooth earphones… buds… whatever. Problem: Saying more than “Hi” to a man who has trouble talking without shutting off or removing one ear… eh… bud. Say what!!?? Answer? Wave a lot and agree that the dog is very pretty. Sigh. Don’t stop. You could have stopped to talked… Want me to go back? Well, no, but next time…

Good news! Sweating from exercise and not from menopause (which I do NOT have) or the heater going mad.

Last year when I didn’t push myself walking I tore my right foot fascia. I guess it doesn’t matter which foot it is really. Oh well. There it is anyway.

Lordy. I think one of the fish just let one.

It is impressively difficult to take notes on my phone while letting doggie “break” (not sit at heel). On second thought maybe, I shouldn’t… nah. She likes it and spends my time laughing at the nonsense I’m poking at in my other app like a demented little old lady – which I definitely am NOT.

It’s so funny when Word can’t figure out what word I can’t spell so I have to depend on the Google voice feature to figure out what I can’t spell. I don’t feel too bad because Word doesn’t know how to spell it either.

These are a few of the things I struggled to take note of during our walk (all that stuff before this did too, but it seemed like too much):

That looks like spit on the sidewalk. Nope. It’s glass. Quick, evasive maneuver!

I shouldn’t have had all that coffee. (I didn’t know I was going to walk so far. You can’t hold this time against me.)

I remember the time the kids and I stopped and gave food to a homeless man who was sitting at the offramp at a local freeway. He graciously declined. Why? No teeth. Sigh. How am I supposed to teach the kidlets to be gracious? LOL

Oops! The front door just slammed. I thought I put a cat toy in it. Guess not.

I have happiness on my face. The sun was out all morning even after I didn’t get up on time. We ignored the forecast that said it was going to rain any minute and ignorantly (and slowly) headed out the door.

We seem to take forever to get ready because I have to decide what to listen to: always a painful and lengthy affair, and I have to remember how to put Bailey’s prong collar on. Yep, prong collar. I finally don’t have to deal with a dog who pulls anymore. (It’s too much to explain now. Just trust me on this one.)

Oh wow! Maks (the oldest male cat we have) is chittering at a squirrel or maybe a cat but probably not at a dog or a cat. Cross people and cars off too. So funny. They have examples of chittering cats on YouTube. Check it out.

What was next? (We’re still on what I was thinking during our walk.)

Okay, next is the word: distance. Dunno why that’s there. Maybe because we went about farther than we’ve gone before? We actually did!

Runtastic (the app I use to map and measure my walks) always summarizes my activity when I stop it. My phone (another app – Great Courses Plus) keeps talking while Runtastic tells me all about my walk. She takes forever. Honestly, I don’t care about my kilocalories. Winston Churchill’s who died? Blast!

Speaking of the Runtastic woman, she counts down to zero while I’m starting out on my walk. I have no idea why I added that to my list. Hmm…

And the last item on my ADHD walkabout list: small ears and Bluetooth. I’m getting new glasses. They will be children’s glasses. My sunglasses are children’s glasses – tiny head. I have around the ear Bluetooth headsets. I simply cannot keep the little buggers on. I’m going to tell the kids it’s because of my glasses, but you and I will both know that it’s because my ears, head, and eyes are all too small.

We made it home just in time to meet our mail lady at our door. She gave Bailey the ritual bone. She is devastated when Mary (mail lady) isn’t the one leaving the mail. I have to have a Milk Bone (small) ready for those days. Such a sad doggie!

Okay, time to shut the front door. I’ve cooled down and my tiny amount of sweat has dried. I’m freezing.

Now, ADHD and Bipolar Disorder, what to do about them? I was listening to a class on Winston Churchill during our walk. The professor said that Churchill was at his best when he was able to laser focus on a problem.

Laser focus. I wonder what that feels like when you actually WANT it to happen? So far I’ve experienced it mainly when I’m not medicated or super interested in what I’m doing / learning or am having a manic episode. The mania seems to help to slow the rapid fire of subjects somewhat. I would also say that the remaining subjects also feel like I’m more engaged in. I like it.

So should we treat the mania? First? Should we treat the ADHD? First or second? Chicken or egg? Seriously? Who came up with that stupid saying? Chicken or egg. How about duck or egg, opossum or roadkill, mini car or accident? Alexa or music from the ’40s? Something like those.

I will continue to seize my good days and to strive to do what I can to enable me to have more of them. I’ve applied to enter an intensive group training to teach me how to live successfully as a person who has ADHD. I guess that answers it. Since my Bipolar meds don’t seem to ever want to be well adjusted I’m going to guess that ADHD will be coming before the Bipolar egg.

Have a great day!

 

Un-niche-able – the Next Day

tday_across_honey_streetI have an announcement to make. I’m going to be 56 for a few more months…. or is it 55? Well anyway, I have ADHD and am a manic bipolar individual so let me think on it for a bit okay? Sigh. It’s late and I’m tired and the dog wants to know why in the world I haven’t taken her out yet! Sorry baby. That’s the dog baby. Um, her name is actually Bailey. Uhh. Slow down! That’s the manic bit – obsessing on one thing and going on and on.

[And this would be a big change in the conversation.]  You know sometimes things become clear, oh so clear… and then their bellies bust right out of those tight pants and they know how convoluted they are. [What??] I mean honestly… I spent almost two hours tonight preparing some documents everso carefully. I was so sure that anyone who could use a crayon could follow it… or I thought so.

I was supposed to be studying. I really want to finish this course! I’m learning so much. But, nope. It’s been hours and I still haven’t started. It very much annoys me. Oh and the documents I’ve been making so “clear” were for my Mom. No pressure. No expectations that I can’t possibly meet. Actually, I’m not sure she has any expectations of me other than the negative ones. The expectations that all end in failure.

I’m un-niche-able. I’m sorry. No one’s going to suffocate me in expectations of failure anymore. This is my un-niche and I’m keeping it!

I spent all this time getting it set up for her so that we wouldn’t have any conflict, as we always do when it comes to going over this stuff. I thought I’d made it so clear this time. She could just print it all and follow along with the notes that were even colorfully numbered. I even put the name of each file right in the text of the email so she could see where everything came from.

It was all very clear. Just read the email first, as requested, print it, then open and print all the pdfs that were attached. Simple? Not on your life.

I’m sorry if I sound rather like a petulant child, but I kind of feel like one. Huh. There has to be another way.

And this brings me to what I’m ruminating on tonight.

Why are people so uninterested in learning about each other?

At T-Day, I tried to explain to a family member (who will have a psych degree this summer) about how I was diagnosed with ADHD about two years ago, but besides giving me medication they haven’t taught me anything about the illness or how it might interplay with Bipolar Disorder. It seems to me that the ADHD mixed with my ever-present manic-ness would be kind of interesting.

Fascinating stuff. Right? For a psych major? UUUUUuuuummmmmmMMMM NOPE! Not on your bloody life. Talk about a snub and a dismissal. OMG! I totally forgot she’s royalty. EEeerrrttt! Stop right now! I guess I shouldn’t go down that road. Insults from childhood are coming to mind. Ick.

So what’s the deal? As I am finally embracing my un-niche-able-ness I’m getting pretty excited. When I’m excited, as you might guess, I want to “share the good news” with at least someone… if it can’t be with everyone. I was brave and I settled on just one someone. I hoped it was a safe someone. I miss judged. Next time, I’ll think longer on who I trust with my soft underbelly. Get my drift?

You already spotted the Un-Niche all over my face right? Yep. It was the royalty.

Dang. How do I slow this bus down a bit?

Frankenstein – Bipolar & ADHD

Frankenstein-tumblr_ovgh5egVdd1wzx3t8o1_1280 I’m aware, that when given the chance, I will, without question, talk until the air has been sucked out of the general area and everyone has passed out. So normal.

Anxiety – After I graduated, and a few weeks had passed I could tell I was under stress from that. My anxiety has gone down. It did get better, for a while. I got to the point where I didn’t quite feel like my brain has been stuffed full of raging bees. Awesome!

ADHD – I was under the assumption that I was taking Ritalin to help me focus my attention so I could do well in my classes. I was always confused when my med provider asked me if I felt the Ritalin she was prescribing was helping me to focus better. I always said, and continue to say, “Um… I guess so.” I’m manic! What does she want me to say? I work very hard when I meet with her to sit, shut up, and answer her questions honestly. She terrifies me. What if I answer wrong and she changes my meds again? I’ll say something than think, “Crap! Why did I say that?” I always say that I guess it was working well. I suppose. Now I think that I was wrong.

More ADHD – I accepted the diagnosis of having ADHD because it was about not being able to focus on one thing at a time and I knew I couldn’t do that. But, being Bipolar was always the main objective of both my counseling sessions and appointment with the med woman.

Bipolar 1 – I assumed that my Bipolar was worse (or more dangerous to me) than ADHD could be. Wasn’t it?

You know how a doctor will sometimes leave a small tube that goes through an incision so that the area can drain and heal properly?

Yeah, I don’t know where I was going with that—

Switch – I have some ideas that I think are pretty good. I’ve done one or two or three big projects that have come out great. The other 45 ideas that are going around in my mind appeared to be stuck in orbit. I remember the video I watched on YouTube yesterday about ADHD and I was shocked. Frankenstein!

FRANKENSTEIN – I’ve come to think of Bipolar/ADHD as a Frankenstein type of symbiotic relationship. I can’t imagine why my diagnoses has always focused upon Bipolar Disorder. In counseling I talk faster and faster and cover an impressive variety of topics.

Pressured Speech (Bipolar) – Thought very little about ADHD or how to deal successfully with it. I’ve been taking medication for it for three years. In that time no one has talked to me taught me to handle it. Why not?

FRANKENSTEIN – Why hasn’t anyone explained how the two disorders interact, and how the medications for each may also affect each other. (“Do you think that the Ritalin is making your mania worse?”)

I have been primarily a mixed state, high functioning, Bipolar type 1 for years now. I always thought that my constant mental zooming about was just my amazingly stunning mania. (While I mostly talk about my being manic lately, let me just say that depression has played a big part in my mental health too.)

My daughter went with me to my last counseling appointment. We talked about my inability to stick with one thing and see it through to completion and how it was impacting her. Basically, I’m driving her bonkers. These are some of the things that I do: TALK CONSTANTLY NO MATTER WHAT WE ARE DOING, change topics as fast as I talk, pick up a pile of laundry in the living room to put it away, stopping to talk to our beta fish (Victor and Batman) and feed them a few dried wormy things and set down the laundry, forget that I had a mission with the laundry, see that the dog/cats water bowls are empty and fill them, read 1.75 pages in a book. What was I doing? Let the dog out to do her business. Hours later I discover the laundry next to the fish… you get the idea.

My new counselor, my daughter and I decided that I need to focus on being able to focus. Yes, my Bipolar mania hops it up like jet fuel in a race car, but with knowledge and tools to help me with my ADHD and settle on one thing, even for an hour, I might just begin to get a handle on my anxiety/stress and even mania.

Maybe. This is stressing me out. Bothering my daughter this bad is building an anxiety that is part of everyday life. Sigh…

Who knew that pressured speech and mania aren’t the same thing as ADHD? I really don’t understand what the hell is going on. I feel like my brain has been sewn together with blue and green colored twine and slip knots.

One final thing: It has taken me three days and four hours to type this. Just kidding. Two days. Honestly, I have no idea. I need a time-out.